Packed red blood cell transfusion affecting phosphatidylethanol concentration.

Area of Science:

• Clinical Toxicology
• Biomarker Analysis
• Transfusion Medicine

Background:

• Phosphatidylethanol (PEth) is a sensitive biomarker for recent ethanol consumption, crucial for monitoring alcohol abstinence, especially in organ transplant candidates.
• PEth is stable in stored blood products and can be transfused, potentially leading to elevated levels in recipients.

Purpose of the Study:

• To investigate the impact of packed red blood cell transfusions on phosphatidylethanol concentrations.
• To determine if a single unit of red blood cells can cause iatrogenically elevated PEth levels.

Main Methods:

• Prospective observational study of 50 subjects receiving one unit of packed red blood cells.
• Whole blood PEth concentrations were measured pre- and post-transfusion using liquid chromatography-tandem mass spectrometry.
• Hemoglobin and hematocrit levels were also monitored.

Main Results:

• Four subjects (8%) showed an increase in PEth from negative to positive post-transfusion.
• Six subjects (12%) experienced an increase in PEth beyond the coefficient of variance, with one showing a significant rise.
• No subjects exhibited a decrease in PEth beyond the coefficient of variance.

Conclusions:

• Patients receiving blood transfusions may exhibit iatrogenically elevated PEth concentrations.
• Interpretation of PEth results requires caution in individuals who have recently undergone blood transfusions.